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TOS and massage?
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TOS and massage? - September 28, 2005 12:28:00 PM
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fixedgear
Posts: 16
Joined: August 3, 2005
From: NY
Status: offline
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I'm looking for a little advice. I know this is difficult without seeing the patient. I'm an LMT. I have a client who came in with neck pain that refered in to his whole arm. He had been to a chiro and they said his shoulder was "out" and adjusted him. I worked on him for an hour focusing on the levator scap/rhomboid area since he had pain there, his scalenes and his chest/pec minor and just overall work to the whole neck shoulder area. When I was working on his scalenes i had them a little on the stretch and he said that made his arm numb. I was conservative with the work I did since he hadn't had any medical treatment or diagnosing. I strongly urged him to see an MD or PT before he came back to see me, but he didn't want to do that since he didn't have insurance. He came back to see me again last night, he said he saw an MD and had x-rays and they were fine, I don't know if that is normal he kind of seemed like he was making it up. He also said he felt alot better after the first tx. So I did the same as before. He had alot of very intense referall pain when I was working on his levator attachment and his superior rhomboids, and compression to pec minor makes the pain go away.
SO....I don't know that I should continue seeing this client since I don't have the education to be deciding what's going on exactly but at the same time he won't go get the medical attention that I feel he should. There's also a little part of me thinking that he could be in worse hands and maybe I should do what I can. Any words of wisdom? Sorry for the long post.
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Re: TOS and massage? - September 28, 2005 12:29:00 PM
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fixedgear
Posts: 16
Joined: August 3, 2005
From: NY
Status: offline
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Sorry....I'm not diagnosing him with TOS,just didn't know what to put int he subject line.
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Re: TOS and massage? - September 28, 2005 1:14:00 PM
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samuelmagnus33
Posts: 4
Joined: June 13, 2005
Status: offline
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Consider explaining to the patient what your comfort zone is regarding treatment. Patient's need to be accountable for their bodies and part of this accountability is listening to the advice a professional (such as yourself) is giving to them.
If nothing goes wrong no big deal. But, if you suspect upon exam or intuition that something else may be going on you should refer out. If something goes wrong you have to be prepared to live your decision to treat this patient.
Money or lack of insurance should not guide your choices, sound clinical reasoning should.
Hope that helps,
Samuel
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Re: TOS and massage? - September 28, 2005 3:31:00 PM
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Shill
Posts: 1098
Joined: February 13, 2003
From: Madison WI USA
Status: offline
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Fixed,
I dont imagine you are all that cheap for him to continue to pay you out of pocket. Money from one or two visits with you might just cover that visit with the PT, or MD. If he trusts you, he'll use it for that purpose.
_____________________________
Steve Hill PT
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